Global, regional, and national epidemiology of nasopharyngeal carcinoma in middle-aged and elderly patients from 1990 to 2021.

Background: In recent years, changes in the incidence and mortality rates of nasopharyngeal carcinoma have occurred globally, across various regions, and among different countries. As a high incidence group, it is necessary to study the prevalence trend of middle-aged and elderly people.

Methods: Detailed information on NPC in middle-aged and elderly patients from 1990 to 2021 was collected from the Global Burden of Disease Database 2021 (GBD2021). Adopted incidence, mortality, disability-adjusted life-years (DALYs), sociodemographic index (SDI) and corresponding Estimated Annual Percentage Changes (EAPCs) to assess the burden of NPC in middle-aged and elderly patients. Additionally, a global risk attribution analysis was conducted, and a Bayesian age-period-cohort (BAPC) model was applied to project the global burden of NPC in middle-aged and elderly patients from 2021 to 2035.

Findings: Globally, the incidence cases of NPC in middle-aged and elderly people increased by 58.2 %, the numbers of death increased by 33.8 %, and the DALY increased by 42.1 %. However, the EAPCs values and upper limits in incidence, mortality and DALY rates were all less than 0, indicating a decreasing trend of incidence, mortality and disease burden. Both incidence and mortality rates were decreasing in high-incidence territories. Most regions were negatively correlated with the sociodemographic index. Males had obviously higher incidence and mortality of NPC in middle-aged and elderly patients than females. The highest incidences of nasopharyngeal carcinoma in middle-aged and elderly males were in the 65-69 age group, and the incidences in females did not change much among different age groups. We found that Alcohol use, Occupational risk and Tobacco were the major risk factors for NPC-related mortality in middle-aged and elderly patients.

Conclusion: Controllable etiology should be effectively controlled in the future.

Data availability: The data sets generated and/or analyzed during the current study are available in the GBD repository (https://vizhub.healthdata.org/gbd-results/). Data will be made available on request.